Evaluation of "Real BVM Help" for Improving Manual Ventilation Quality in the Prehospital Setting: A Before-After Manikin Study

Background: Manual ventilation is a critical skill for emergency medical service (EMS) members. However, it is challenging in terms of correct ventilation rates and tidal volumes, with potentially severe adverse effects of hypo- and hyperventilation. Measuring the quality and involving real-time feedback may be effective in optimizing of manual ventilation. Methods: Data acquired retrospectively from a quality management project in 143 advanced emergency medical technicians were included. They performed bag ventilations on an intubated adult manikin for two minutes without any feedback system, and then another two minutes with the Real BVM Help ^® device. Ventilation rates and volumes and their allocation in correct/recommended ranges were determined. Results: With the feedback device, correctly applied ventilation rates increased by 21% (63.6% in the correct range without vs 84.6% with the feedback device; p<0.001), and ventilation volumes improved by 41% (27% in the correct range without vs 68% with the feedback device; p<0.001). Without the device, the average ventilation rate was 10.5 ±3.1/minute, compared to 9.5 ±1.9/minute with the device. Ventilation volumes amounted to 370.6 ±84 mL without Real BVM Help ^®, while when using it, 415.5 ±33.1 mL was noted. Conclusion: Our data demonstrate significant improvements in ventilation rates and volumes when using a ventilation feedback device. This manikin study suggests a ventilation feedback device being beneficial for the use by EMS members, but our findings must be further validated in real-life conditions.